WASHINGTON — With Congress scrambling to put together health care reform — a draft bill circulated Friday by Massachusetts Democrat Sen. Edward Kennedy's health committee would guarantee all Americans health insurance — stakeholders are uncertain how HME will be treated as the reform takes shape.
But Sen. Sherrod Brown, D-Ohio, told HHS last week DMEPOS competitive bidding shouldn't be a part of it unless the program is fixed.
In a June 2 letter to HHS Secretary Kathleen Sebelius, Brown said he was concerned because CMS has not made the changes necessary "to avoid the problems that occurred during last year's bid process.
"In both the Cincinnati and Cleveland markets, two-thirds of the DME providers that bid to serve the areas were rejected," Brown wrote. "Moreover, many of the bid winners did not have a physical location proximate to the service area, nor did many of the winners have a track record of the product and services [they] won …
"These counterproductive bid results occurred in all of the bid areas, not just Ohio's, and are the reasons Congress delayed the bid program last year."
Brown also told the HHS secretary that CMS should consider implementing an "any willing qualified provider" provision to "avoid massive business closures and consumer access problems."
Brown, who serves on the Senate Health, Education, Labor and Pensions (HELP) Committee, which Kennedy chairs, urged Sebelius to rescind the competitive bidding Interim Final Rule "and understand how the bid program must be changed to be successful."
The text of Brown's letter follows in its entirety:
Dear Secretary Sebelius:
On January 16, 2009, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register an interim final rule on the durable medical equipment (DME) competitive bidding program. The rule took effect on April 18, 2009, and is related to Congress' July 15, 2008 enactment of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
I am writing because I am concerned that CMS has not made changes to the competitive bidding program to avoid the problems that occurred during last year's bid process. In both the Cincinnati and Cleveland markets, two-thirds of the DME providers that bid to serve the areas were rejected. The job losses associated with such extreme business disruption contravene the goal shared by the Obama Administration and Congress to stem U.S. job loss during these challenging economic times.
Moreover, many of the bid winners did not have a physical location proximate to the service area, nor did many of the winners have a track record of the product and services [they] won. Furthermore, many of the winners were not in compliance with state licensure requirements.
These counterproductive bid results occurred in all of the bid areas, not just Ohio's, and are the reasons Congress delayed the bid program last year. We wanted CMS to reconsider some of the fundamental decisions that drove these outcomes.
I understand that when CMS issued the January 16, 2009 interim final rule, it was developed without input by affected parties. I urge you to take a close look at this rule and meet with affected parties and gain their input on how the bid program should be modified to avoid the problems of the 2008 bid program. For example, CMS should consider implementing an "any willing qualified provider" provision to avoid massive business closures and consumer access problems.
While the MIPPA provisions addressed near-term concerns with the program, we expected that CMS would conduct a more thorough, collaborative rulemaking process given the overwhelming level of Congressional and stakeholder concern during initial implementation. Congress intended that CMS actively engage all stakeholders to make substantive changes to the bid program before any further implementation of the program, including rulemaking.
I urge you to consider rescinding the January 16,2009 interim final rule and engaging stakeholders to understand how the big program must be change to be successful. I would be glad to discuss my concerns with you more in depth, and I look forward to working with you on this important issue.
Sincerely,
Sherrod Brown
United States Senate