Round One Costs, Errors, Transition Get Attention at Open Door

BALTIMORE–Last Wednesday’s Open Door Forum started out as same
ol’, same ol’–reemphasis on accreditation deadlines and basic
information on competitive bidding–but when CMS officials began
fielding questions from the teleconference’s more than 400
listeners, things got a bit more interesting.

Eric Sokol, executive director of the Power Mobility Coalition,
pulled no punches when he asked if CMS’ touted $1 billion savings
from competitive bidding had taken into account the administrative
cost to implement the program.

Citing costs including hiring the CBIC, convening meetings of
the Program Advisory and Oversight Committee, numerous
“man-hours” spent pouring over files and the amount of
resources devoted to educational outreach, Sokol asked if the $1
billion was “above and beyond all that investment.”

“We would have to check into that” was the answer
CMS gave Sokol.

Marcia Nusgart, representing the Coalition of Enteral Nutrition
Manufacturers, received a more direct answer–well, sort of–when
she asked whether there would be a “grace period” for
enteral nutrition suppliers who did not win a bid before the round
one implementation date of July 1.

“The contract offers were sent out [March 20 and received
on March 21], so if you’re a skilled nursing facility or an enteral
nutrition supplier … you can start planning and preparing
based on that information,” CMS answered. “The law
requires [a] contract for furnishing items under Part B, so once
those contracts are in effect, only the contract suppliers can
furnish those items that are paid for under Part B.”

One provider called in to ask what steps round one providers who
feel their bids were denied due to CMS’ error should take to
rectify the situation.

CMS’ Joel Kaiser answered that there is a process in place for
providers to voice their grievances. “The supplier can
contact a customer service representative at CBIC and get more
detailed information on the reasons their bid was excluded, and
then, based on that information they can request that there be
further research into the specific information surrounding their
bid,” Kaiser said.

Once the CBIC is done with the review process, “then
they’ll be reporting to us, and CMS will work with the CBIC to
further review the bid situation,” he continued. “And
then, ultimately, we will be replying back to the bidder on the
outcome of the review.”

Kaiser went on to say that the case-by-case review could take up
to 30 days, after which time CMS would give “further
information as to what the next steps are.”

The caller then asked how the transition for round one providers
would be handled in terms of time frame and coordination.
“It’s not finalized yet. I can’t give you specific details.
There will be specific guidance provided in the near future on
exactly what that process will involve,” Kaiser said,
although he did note there could be instances of
“crossover” of providers involving rental equipment for
which Medicare had already paid through a certain month.

The answer remained the same–“It’s not finalized yet. I
can’t give you specific details”–when the same caller asked
whether patients would be assigned to new providers or how that
transfer would happen in the 10 bid areas. “We’ve laid out a
plan and a process,” Kaiser said, “… but it could
change.”

An “intense” education campaign for all affected
participants of the bidding program will be instituted before the
July 1 start date, Kaiser said. The campaign will include a series
of “MLN Matters” articles and conference calls for
providers, according to CMS.

On further questions concerning specifics of bids in round one,
CMS said it would refrain from answering until after all contracts
were signed. That deadline was April 3, and Kaiser said the agency
is on track to announce the round one winners in May.

CMS continued to direct questions concerning competitive bidding
to the CBIC Web site at www.dmecompetitivebid.com.

Agency officials also made the following points during the Open
Door:

–Suppliers planning to bid in round two must be accredited or
pending accreditation by May 14, 2008, to submit a bid. Suppliers
must complete the accreditation process by Oct, 31, 2008, to be
awarded a contract.
–CMS has released a revised Advanced Beneficiary Notice form.
Suppliers have a six-month transition period to begin using the
revised form and will be required to use it by Sept. 1, 2008.

The next Open Door call is scheduled for Wednesday, May 14,
2008.