Divide Grows Greater in Competitive Bidding War of Words

WASHINGTON — How are things going with competitive bidding? It depends
who you ask.

Round 1 of the Medicare program began Jan. 1 in nine cities
across the country and, according to CMS, it’s working just
fine.

“We are pleased to report that implementation of the program is
going very smoothly,” CMS Administrator Donald Berwick said in an
agency press release issued yesterday. “We continue to deploy a
wide array of resources across all of the competitive bidding areas
to address any concerns that may arise.”

But the American Association for Homecare has a very different
view.

“Six weeks into Round 1 of the bidding program and AAHomecare
has seen enough,” association President Tyler Wilson said in a
letter to members sent earlier today. “Competitive bidding for home
medical equipment must be abolished. The home care system should
not be characterized and viewed merely in terms of the lowest cost
and who can provide it most cheaply.”

CMS’ program design is “faulty and its administration has been a
lesson in poor planning, arrogance and clumsiness,” Wilson
continued.  For that, he said, the agency bears the blame.

But it’s Congress that authorized the program, and it’s Congress
that must stop it, he said: “The philosophy behind bidding as a way
for Medicare to manage, deliver and reimburse for home medical
equipment is simply wrong-headed and misguided. For that, we can
blame Congress. Lawmakers can be roundly criticized for mandating
the program that is now causing such terrible financial hardship
and economic dislocation.

“Congress bears the responsibility and we should let them hear
our anger.”

A toll-free hotline sponsored by the association has recorded
more than 200 complaints about the program, the majority from
beneficiaries.  The “alarm bells are sounding” that Round 2 of
competitive bidding will be implemented without considering the
faults of Round 1, Wilson said.

Scheduled to be bid this year, Round 2 will add 91 cities
— including New York, Los Angeles and Chicago — to the
national bidding project.

“Looking ahead,” Wilson added, “nothing about CMS’ handling of
the program should give anyone comfort. The Medicare agency has
been alarmingly dismissive toward a host of issues and completely
unwilling to do any self-examination.”

CMS’ release said the agency had received “only a handful” of
 beneficiary complaints.

“CMS continues to monitor the implementation of the program very
carefully,” Berwick said. “We urge all stakeholders to bring any
issues to our attention in order for our caseworkers to resolve
them as quickly as possible.”

But Wilson said “the only way to stop the problems is to stop
the program. Congress must step in and enact legislation that ends
bidding for home medical equipment.”

And that needs to happen fast, he said, “while there is still a
community of home care providers that can put the pieces of a
robust home care system back together. If Congress fails to act,
the economic fallout and the harm to the home care system and those
that rely upon it will be irreversible.”

Read the entire CMS press release.

Read the full AAHomecare letter.

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