Stack of Letters from Congress Grows; CMS’ Weems Writes Back to Rep. Altmire

WASHINGTON–Joining the growing numbers of those voicing major
reservations about DMEPOS competitive bidding, over the last 10
days, three senators and four representatives have called on CMS to
postpone further implementation of the program.

In an April 1 letter to Michael Leavitt, secretary of the U.S.
Department of Health and Human Services, which oversees CMS, Sen.
Sherrod Brown, D-Ohio, called competitive bidding “seriously
flawed” and said it would undermine beneficiary access and
care.

In bullet-item format, he noted numerous problems with the
program and urged HHS to “act quickly to fix the problems
… and avert the serious ramifications–both for Medicare
beneficiaries and suppliers–that will surely result should
implementation continue unfettered.”

On April 2, Sens. Arlen Specter, R-Pa., and Robert Casey, D-Pa.,
sent a letter to Leavitt asking him to extend the winning bidder
contract review period (which ended April 3) and to delay
implementation of round one.

“The delays we request are clearly warranted by the very
serious potential errors made by CMS and the CBIC in this
process,” the senators wrote. “If a large number of
bidders have been disqualified in error, it is entirely likely that
their re-inclusion may substantially impact the bid outcomes. Thus,
it is imperative the current schedule be delayed so that all
necessary corrections can be implemented.”

On March 28, Rep. Ric Keller, R-Fla., sent a letter to acting
CMS Administrator Kerry Weems telling the CMS head he had discussed
the issue of bid disqualifications with several providers.

“The business owners I met with indicated that 40 percent
to 70 percent of their business is generated from Medicare
beneficiaries. Their ineligibility to participate in the DMEPOS
program will negatively affect their businesses as a result of
clerical errors made by CMS. It will also cause beneficiaries to
lose the quality service they have come to expect from these
providers as well as their choice when seeking out medical
equipment,” Keller wrote.

Three other Republican representatives from Florida–Lincoln
Diaz-Balart, Mario Diaz-Blart and Ileana Ros-Lehtinen–sent a
similar letter to Weems on April 3.

The members of Congress are the latest in a widening spectrum of
those opposing the project, which is set to take effect July 1. But
theirs weren’t the only letters posted last week.

Earlier last month, Rep. Jason Altmire, R-Pa., spearheaded a
letter to Weems from 120 House members asking CMS to “provide
detailed answers” to a number of questions about round one of
bidding and expressing concern about round two because “CMS
is expanding the program before the first phase has started and the
impact on beneficiaries’ access to DMEPOS can be
evaluated.”

The House letter recommended that CMS create additional measures
to ensure “the healthy participation of small
businesses” in both rounds.

In a response received last week, Weems wrote Altmire that CMS
had initiated “a number of policies to ensure the active
participation by small suppliers,” including:

–Working with the Small Business Administration to establish a
new definition for small suppliers reflective of the DMEPOS
industry;
–Not requiring suppliers to submit bids for all product categories
because it may be difficult for small suppliers to furnish all of
the product categories in the competitive bidding program;
–Setting a 30 percent target for contract awards to small
suppliers for each product category; and
–Permitting small suppliers to form networks if they cannot
service an entire competitive bid area.

“In addition to the regulatory provisions, we provided
extensive education and support to all suppliers including small
suppliers, during the bidding process,” Weems said in his
letter, adding that CMS had more than doubled its target goal with
small suppliers making up “a significant number (64 percent)
of the suppliers being offered contracts under round one of the
program.”

Regarding the timeline for round two, Weems wrote: “As we
proceed with each stage of round two, we are taking into account
our experience from round one, as well as the successful
demonstration projects conducted several years ago. For example, we
announced the metropolitan statistical areas and product categories
that will be phased in under round two of the program earlier this
year so that suppliers in those areas would have time to meet
quality standards and become accredited. We are also upgrading the
online supplier bidding system.”

Said Weems, “I assure you that I will continue to take
steps to work with suppliers to ensure that Medicare beneficiaries
have access to quality DMEPOS items and services at reasonable
prices.”