BALTIMORE — As the forward move continues on DMEPOS competitive bidding, stakeholders said last week they won't let up on pressing CMS to remedy the project's numerous flaws.
The agency got an earful at the June 4 meeting of the revised Program Advisory and Oversight Committee, a 17-member panel chosen by CMS in January to offer input on bidding implementation. PAOC members, as well as attendees, raised a myriad of concerns ranging from winning bidders' experience and track records to transfer of winning contracts.
Walt Gorski, vice president of government relations for the American Association for Homecare and a member of the PAOC, said the meeting was a "productive opportunity to get patient and provider concerns in front of CMS."
Among them, the association has questioned how CMS calculates capacity to serve a market, how the agency sets single payment amounts, the sustainability of prices after implementation of bidding, transparency of the bid process, financial documentation issues, the impact on diabetes patients and the impact of the bid program generally on stability for patients and providers.
"AAHomecare will be working with the PAOC co-chairs to develop agenda items for future discussions," Gorski said. "We'll also be following up with CMS on the key issues that were raised during the meeting."
Meeting attendee Tim Binkley of Valentines Diabetic Supplies in Roswell, Ga., said he also would be keeping up with future meetings. He's very concerned, he said, about patient accessibility to quality products under the bidding program.
"Our concern is that we wouldn't be able to provide the most widely used and popular [diabetic] meters on the market that many patients use," he said.
Reimbursement for diabetic supplies was cut by a massive 43 percent under 2008's aborted Round One. "You would not be able to provide the major brands under a 43 percent reduction," said Binkley, whose company serves patients in 30 states. "Most of us couldn't be in business with a 43 percent cut."
The only way even to come up with a bid that low would be to supply "products that are not used by most diabetics," he said.
Binkley also said he is worried that, as in the first Round One, CMS will once again allow bidders to win who have no experience in the product category, let alone in the bidding area.
Binkley isn't the only one concerned about the quality of both products and services.
During a public comment period, one provider said numerous business suitors surfaced after the contracts were awarded last year and sought to purchase her company because they thought she had been a winning bidder. None was qualified to be a Medicare provider, she said, noting that this smacked of "selling the beneficiary."
Seth Johnson, vice president of government affairs for Exeter, Pa.-based Pride Mobility Products, said the issue of selling a business and a contract is a competitive bidding loophole that must be closed.
"Many winning bidders last year tried to sell their companies once they secured a [contract]," Johnson explained. "The issue raised at the PAOC was that CMS should prohibit the sale or transfer of a winning bid, essentially to force winners to provide products and services at the agreed-upon price, and also hopefully prevent bottom-feeder bids that are simply submitted to secure a bid only to turn around and sell it."
Johnson said CMS did not state a position on the matter. The issue will be tackled at future PAOC meetings, stakeholders said.
Even as efforts continue to get CMS to make significant changes to the competitive bidding project, attempts are also afoot to eliminate it altogether.
"AAHomecare is working with congressional offices and other HME stakeholders on several fronts, including a bill to repeal competitive bidding [and] legislative reforms of the competitive bidding program," said Michael Reinemer, vice president, communications and policy. Reinemer said he would have more information "when those efforts start to gel."