WASHINGTON--With the July 1 implementation of competitive bidding closing in daily, industry stakeholders spent last week urging federal legislators to consider the impact of the program on small business.
Attendees at American Association for Homecare's Legislative Conference March 4-6 followed up congressional visits, pressing senators and representatives to sign on to letters to CMS expressing concern about what will happen to small providers under the bidding program.
The House version of the letter was authored by Rep. Jason Altmire, D-Pa., chairman of the Small Business Subcommittee on Investigations and Oversight, which last fall, convened a hearing on the program's possible effects. Sens. George Voinovich, R-Ohio, and Sherrod Brown, D-Ohio, authored the Senate version.
Addressed to Acting CMS Administrator Kerry Weems, the Senate letter states: “We believe that this payment strategy, as currently structured, could significantly reduce [DMEPOS] quality and access and have a devastating impact on small businesses throughout the country.”
The House letter, among other things, asks that CMS “provide detailed answers” to the following questions:
-- Of the 4,529 suppliers providing DMEPOS in the 10 competitive bidding areas, how many suppliers submitted bids for each of the product categories in each of the 10 bid areas? How many of those companies were small businesses?
-- In round one, how many contracts does CMS expect to issue for each product category in each of the 10CBAs? Are initial bids sufficient to ensure adequate access to each product category in every initial CBA? Does CMS have a strong indication that most of the selected suppliers will elect to participate based on the median bid price?
-- For round one, will CMS be able to meet the 30 percent small supplier participation target that was established in the final rule dated April 2, 2007, for each product category in each CBA?
-- Did CMS receive any applications from networks of small suppliers? If so, how many, for what product categories, and in what competitive bidding areas?
“We are also concerned,” the House letter continues, “that CMS is expanding the program before the first phase has started and the impact on beneficiaries' access to DMEPOS can be evaluated. Based on CMS' timetable for implementing round two in 70 areas, it is unclear how CMS can modify implementation details of round two based upon its experience in implementing round one. We recommend that CMS consider creating additional measures to ensure the healthy participation of small businesses in both rounds.”
In soliciting House colleagues to sign on to the letter, Altimire explained, “While we support efforts to improve the Medicare program and reduce costs, we must also ensure the changes do not unravel the DME small business community, and ultimately limit access to quality care for seniors.”
AAHomecare also asked providers to request that their senators and representatives send letters to Health and Human Services Secretary Michael Leavitt asking him to suspend round one of competitive bidding.
For a sample letter to HHS or to view the House and Senate
letters to CMS, visit www.aahomecare.org.