Early Bidders Run into System Stumbling Blocks

ATLANTA–Web site glitches and lack of key information have
delayed some providers’ attempts to bid in CMS’ national
competitive bidding project–and the 60-day clock is still ticking,
HME stakeholders said last week.

Product category bids in the 10 initial competitive bidding
areas must be submitted by July 13.

“I have absolutely gotten quite a number of providers who have
complained,” said Rose Schafhauser, executive director of the
Midwest Association for Medical Equipment Services. And, she added,
“those are just the ones who called.”

Providers trying to submit bids have been frustrated by trouble
getting registered, a Web site that was down for days, user ID
numbers and passwords that don’t work and an inability to e-mail
the site for help because it won’t recognize their passwords.

At a competitive bidding forum during AAHomecare’s Washington
Legislative Conference June 5, providers reeled off a similar
laundry list of problems with the system and detailed additional
difficulties getting answers to questions.

Cynthia Wilson, general manager of UPMC (University of
Pittsburgh Medical Center) Home Medical Equipment, complained that
because the $6-billion health system is so big, she could not
obtain a credit report for her company, one of the bid submission
requirements. What’s more, she pointed out, two of CMS’ three
designated credit reporting facilities only provide reports for
individuals, not businesses.

“We keep submitting this issue” to the CBIC, Wilson said, “but
no one is able to get us a straight answer.”

Wilson also said she needed help working through the 5 percent
common ownership rule and had a problem with the requirement to
report finances on a calendar-year basis. “We work on a fiscal
year,” she said.

Wilson also reported the problems to Herb Kuhn, CMS acting
deputy administrator, during an appearance at the AAHomecare
conference. “According to statistics, we are the 18th largest
Medicare oxygen provider in the United States,” she told Kuhn, “but
we’re locked out of the bidding because of these
technicalities.”

At a bidders’ conference on Wednesday, the CBIC announced it had
added Dun & Bradstreet to the approved list of credit reporting
companies and that financial reporting on a fiscal year basis was
acceptable. (See “CMS Hosts Competitive Bidding Teleconferences” in
this issue.)

“What we are finding–and, unfortunately, I don’t think it’s a
surprise–gets back to this whole deal that [CMS] is rushing
implementation,” said Don Clayback, senior vice president of
networks for The Med Group. “Because of a rush to the bidding
process, they’ve started the structure but they’re kind of learning
as they go.

“While the people are trying to be helpful on the [phone
helpline], it’s been my experience that if it’s not something very
basic that can be read from a script, then you’re referred to
someone else and you have to leave a voice mail.

“Because of the complexity of competitive bidding,” Clayback
continued, “it’s going to be a difficult process under the best of
circumstances. Given the fact that some information just isn’t
available yet and that the response time to questions has been less
than what they promised, it’s adding to the stress for some
providers.”

Representatives of the CBIC apologized during a bidders’
conference last week for site problems that prohibited providers
from submitting bids. They said those problems should now be
resolved.

But Miriam Lieber, president of Sherman Oaks, Calif.-based
Lieber Consulting, called the bidding process “a landmine,” noting
that several of her clients had tried to submit bids but were
unsuccessful.

In one instance, a downloaded form called for the top three
HCPCS codes in the product category, but Lieber and her client
couldn’t access the information because the CBIC site was down. The
CBIC helpline personnel couldn’t tell them what the top three codes
were and referred them to the Web site. Said a frustrated Lieber,
“We can’t get online to find out ourselves, [they] can’t give it to
me over the phone, so what am I supposed to do?”

For her client to bid only two product categories took two days
to get through, Lieber said. “A lot of it has to do with the HCPCS
codes that aren’t exactly right. Some manufacturers don’t have
pricing, so if you don’t carry a product, you have to be able to
get a price. That makes it hard for a guy to bid.”

In any case, she continued, information about the codes and
other data came late in the game. “They released those top three
codes after Memorial Day. Last time I checked, it was a 60-day
bidding window. If I [wanted] to bid Form B, it wasn’t there. How
is that a 60-day bidding window?” she questioned.

Such difficulties prompted MAMES to enlist the aid of state Sen.
Pat Roberts, R-Kan., Schafhauser said.

“Our whole push through the senator’s office was trying to get
this thing delayed and trying to get [CMS] to understand all the
issues that providers are facing,” Schafhauser said.

She and representatives from Roberts’ office met with CMS
officials on May 25, specifically about incorrect information being
dispensed through the bidding helpline. Schafhauser said she
pointed out that “the people who are on the front lines don’t have
the knowledge [CMS policymakers do] … What if providers are
taking what these people are saying verbatim? One person was told
that it was just HME revenue that counted.”

While the bidding process is a problem in some quarters, it
doesn’t appear to be so across the board.

Liz Moran of the Medical Equipment Suppliers Association said
she hadn’t heard too many complaints. “There have been people who
have had hiccups, but any new system is going to have that,” she
said. “No one has called me and said they can’t place a bid.”

Raul Lopez, director of operations for Bayshore Dura Medical and
president of the Florida Association of Medical Equipment Services,
also said he was not aware of any difficulties but that “the
majority of the [providers] will generally wait until the last of
the bidding process.”

Lopez said he had not yet submitted a bid for his company, which
is located in the Miami bidding area.

While Lieber thinks it is possible that the process will so
frustrate providers that some might simply pull out of the bidding,
the greater fear for her and Schafhauser is that providers will
wait until the last minute to begin bid submission.

“You’re going to have mass mayhem, and what computer system is
going to be able to handle that?” asked Schafhauser, noting that
“now it is just normal times and [people] can’t get through.”

Lieber urged providers not to wait until the end of the bid
window. “There’s time left, but it’s kind of scary. You need to get
going now … People who don’t have their ID numbers, God help
them.”