Bipartisan concern about DMEPOS

ARLINGTON, Va., June 27, 2013—An opinion piece appearing on the POLITICO website by Rep. Glenn Thompson and Rep. Bruce Braley reads: “At a time when bipartisanship is rare in Washington, a majority of members of the U.S. House of Representatives recently came together in an attempt to ensure that the Centers for Medicare & Medicaid Services (CMS) does not put Medicare beneficiaries at risk, when implementing the Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS). This bipartisan group, made up of 82 Democrats and 145 Republicans, is urging CMS to delay further implementation of the DMEPOS Competitive Bidding Program, citing identified abuses and outlining concerns over the agency’s ability to appropriately screen suppliers. Unfortunately, rather than respond, it appears that CMS has decided to run a public relations campaign.

“On Monday, CMS Deputy Administrator Jonathan Blum, writing in POLITICO, defended the abuses. Wrote Blum: ‘The competitive bidding program carefully checks suppliers to ensure they are in good standing with Medicare, meet quality and financial standards—and are licensed and accredited.’ Unfortunately, the evidence by all accounts points to the contrary.

“In Tennessee, CMS awarded contracts to 30 unlicensed suppliers. Since that time, CMS Administrator Marilyn Tavenner has indicated those contracts would be voided. However, the administrator failed to indicate whether bids by those companies would remain, potentially skewing the price point for each product. After removing 30 of the 98 contracts in Tennessee, Tavenner stated that adequate coverage for beneficiaries in the state would still be available moving forward. If that were truly the case, it certainly begs the question of why so many contracts were awarded in the first place.

“CMS’s reaction to admitted misconduct in the DMEPOS program has been lackluster. CMS officials continue to laud the projected savings under the bidding model, yet fail to answer the very serious questions we, as elected representatives, have a responsibility to ask. While CMS would like the public to believe Tennessee was an isolated incident, additional reports of unlicensed suppliers winning bids in Ohio, Maryland, Michigan, California and Florida have followed. Just recently, it has been brought to light that close to 60 percent of the suppliers who won contracts in the Philadelphia market are unlicensed to provide services in Pennsylvania.

“For these many reasons, we have called for a formal investigation by Health and Human Services Inspector General Daniel Levinson. The public must be assured that there are legitimate reasons behind the insistence of moving the program forward, despite the growing number and systemic nature of the abuses.

“We acknowledge the government should take every measure to reduce costs. Furthermore, we believe the Medicare DMEPOS program is unsustainable without the introduction of competitive market methods and other common sense reforms. Savings can and must be achieved through a manner that protects beneficiaries’ access to quality goods and services. But to say the current model achieves this end without knowing to what expense on the part of beneficiaries is a slap in the face to good government.

“In 2011, more than 240 economists and market auction design experts wrote President Obama on the issue, warning that Medicare’s new bidding model would ultimately harm competition and impair patient access, stating “the current program is the antithesis of science and contradicts all that is known about proper market design.” These perceived flaws have now become a reality.

Medicare beneficiaries and taxpayers deserve a system that’s not just labeled competitive, but is competitive. We stand by our letter, as do 225 other members of Congress, and again urge the CMS administrator to do the right thing and delay the program to allow for adequate investigation and correction of these significant problems before moving forward in 100 cities nationwide.” Go online to www.politico.com.