WASHINGTON--Following a congressional hearing on national competitive bidding that opened up grave questions about the program, Reps. John Tanner, D-Tenn.; David Hobson, R-Ohio; and Jason Altmire, D-Pa., are urging their colleagues to sign on to a letter asking for a one-year delay of the Medicare DMEPOS bidding program.
In explaining the request to other House members, the representatives said "multiple concerns have been raised that should be addressed before this program is allowed to go forward."
The letter, addressed to Rep. Fortney "Pete" Stark, chairman of the House Ways and Means Health Subcommittee, which convened the May 6 hearing, follows:
"We write to bring to your attention our continuing and serious concerns with the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program and ask that you support legislation this year to delay the implementation of this program until outstanding issues can be resolved.
"Our overall concern is focused on the implementation of the program thus far and its implications for Medicare beneficiaries receiving high quality health care. Almost four million Medicare beneficiaries will be impacted by round one of the competitive bidding program scheduled to take effect July 1. Eighteen million beneficiaries will be affected by round two, which is scheduled for implementation in July 2009. Our request is legislation that would delay the implementation of this program until outstanding issues are resolved.
"Our first concern is the alleged discrepancies between information submitted by bidders and received by the Centers for Medicare and Medicaid Services (CMS). We have all heard from long-standing companies who have offered quality home care services for decades, but who have been excluded from the bidding program, apparently through no fault of their own. The vast majority of rejected bidders were informed that they have not submitted sufficient financial information, when in many cases, bidders have evidence they had. These rejected bidders have no appeal rights.
"In other examples, reputable home oxygen providers were disqualified for allegedly bidding too low on certain individual items subject to bidding, while other providers based outside the market area were offered contracts for similarly-priced bids. Another serious concern is the reports of companies who won bids to serve beneficiaries in areas where the company has no proximate physical location and where the company has no history of serving. It is possible that contract suppliers may be able to quickly subcontract with local home care providers, but we are very concerned that the suppliers will not be able to meet the needs of Medicare beneficiaries in bidding areas effective July 1, 2008.
"Finally, we are seeking more transparency from CMS as to how bidders’ financial information and service capacity were evaluated and how the single payment amount was calculated. We have heard about numerous data anomalies and believe this information is critical to the bidding program’s success. At the very least an internal review should be conducted to ensure the accuracy and effectiveness of the criteria for future bidding. We all agree that it is of the utmost importance that we protect access to quality medical supplies for all of Medicare beneficiaries and people with disabilities. Therefore, we urge that the implementation of round one be delayed for at least a year."
In an action alert sent last week, the American Association for Homecare said asking members of the House to sign on to the letter will be one of the requests industry advocates take to Capitol Hill during its Washingon lobbying fly-in Wednesday.
"The Medicare bidding program must be significantly delayed so Congress can take a careful look at the program," AAHomecare said. "If you can't attend [the fly-in] in person, please call your senators' and representatives' offices and ask them to support congressional efforts to delay the Medicare bidding program for durable medical equipment and ask them to instruct [CMS] to immediately delay implementation of round one.
"This issue affects everyone in the home care community, whether you are in round one, round two or beyond."
For a report on the House Ways and Means Health Subcommittee hearing, see HomeCare Monday, May 12.
For information on the AAHomecare fly-in, visit www.aahomecare.org.