WASHINGTON--The fierce battle to halt implementation of competitive bidding program heated up on Friday when two senators circulated a letter to their colleagues pressing for a delay “until outstanding issues can be resolved.”
The American Association for Homecare and other industry organizations immediately issued an action alert calling on all providers to contact their senators and urge them to sign on to the letter, which was authored by Sens. George Voinovich, R-Ohio, and Debbie Stabenow, D-Mich.
Deadline is close of business today for signatures to the letter, which is addressed to Sen. Harry Reid, D-Nev., Senate majority leader; Sen. Max Baucus, D-Mont., head of the Senate Finance Committee; Sen. Mitch McConnell, R-Ky., minority leader; and Sen. Charles Grassley, R-Iowa, ranking member of the Finance Committee.
Walt Gorski, vice president, government affairs, for AAHomecare, said there is no target number of signatures. “We need to get as many as we can possibly get in the next day-and-a-half,” he said Friday, adding that time is of the essence because of “how quickly things are moving.”
Both Republicans and Democrats in the Senate are attempting to put together a Medicare package that would include a “doc fix” provision eliminating a 10 percent cut in physician reimbursement. A stay on that cut runs out July 1 (see top story in this issue). Coincidentally, national competitive bidding is scheduled to be implemented that same day in 10 MSAs.
Industry stakeholders are hoping to get a provision to delay competitive bidding in the final Medicare package.
There is also the possibility of a stand-alone bill to stop the program. According to industry insiders, Rep. Fortney “Pete” Stark, D-Calif., a member of the heavyweight House Ways and Means Committee, is poised to introduce a bill that would delay round one for 18 months and round two for an additonal year.
But with any legislation, success is contingent on support.
“The association believes strongly that a delay in competitive bidding is a non-partisan issue and should be approached as one. We are working to gain momentum in the Senate as we have in the House,” said Gorski. “Clearly, we have made inroads, and both lawmakers in the House and the Senate recognize the problems that have arisen with this program.”
Earlier last week, 132 members of the House--nearly a third of its membership--signed a letter calling on the Ways and Means Committee and its subcommittee on health to support a one-year delay in implementation of the program. That letter was authored by Reps. John Tanner, D-Tenn.; David Hobson, R-Ohio; and Jason Altmire, D-Pa.
In addition, Rep. Nydia Velazquez, D-N.Y., who chairs the House Small Business Committee, and Rep. Heath Shuler, D-N.C., chairman of its subcommittee on rural and urban entrepreneurship, also sent a letter last week pleading for a delay in competitive bidding to Ways and Means members Stark and Dave Camp, R-Mich.
Both the House and Senate letters cite examples of significant problems with the CMS bidding project.
“Our first concern is the alleged discrepancies between information submitted by bidders and received by [CMS],” the Senate letter reads. “The vast majority of rejected bidders were informed that they have not submitted sufficient financial information, when in many cases, bidders argue they had.”
“These rejected bidders have no appeal rights,” the House letter points out.
The Senate letter also raises questions about the ability of companies that won bids to service beneficiaries adequately: "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 service. This calls into question not only the capacity of the companies who have won bids to service those beneficiaries, but also whether subcontractors meet the program's new accreditation standards.”
Further, the Senate letter notes, “in some cases, bidding rules explicitly allowed suppliers to offer less choice to seniors based on their lack of experience in the market. As a result, we are hearing from our constituents that companies who won bids have no experience in delivering the product in which they were awarded a contract. We have concerns these situations will lead to poor service for our most vulnerable constituents.”
Both letters also call for more transparency from CMS regarding “how bidders' financial information and service capacity were evaluated and how the single payment amount was calculated,” according to the House letter.
With such questions unresolved, the letters recommend a delay in bidding. “At the very least, an internal review should be conducted to ensure the accuracy and effectiveness of the criteria for future bidding,” the Senate letter advises.
The letters and a list of House cosignatories are posted on the AAHomecare Web site at www.aahomecare.org.