ATLANTA — Providers in the remaining Round One competitive bidding areas should get ready for a rebid. That was the advice from VGM Group's Mark Higley during a March 25 session at Medtrade Spring in Las Vegas.
While the industry mounts a feverish lobbying effort during Congress' Easter recess to get the competitive bidding interim final rule pulled, the outcome of that effort will be too close to call, Higley and others said. The IFR, which requires a rebid of Round One in 2009, is slated to take effect April 18.
Although CMS has dropped San Juan, Puerto Rico, from its original list of 10 cities where the bidding program will be implemented, providers in the remaining nine "better get prepared," said Higley, vice president of development for the Waterloo, Iowa-based member services group. "Get on the Internet and apply for your bidding number," he advised. "CMS officials are ready to go … Maybe we'll get out of it," he added, but if not, providers in the first-round CBAs need to be ready to go, too.
Higley said if the IFR moves forward, he expects a request for bids could come as early as June.
A Friday check with industry lobbyists on the status of the IFR confirmed the industry squeeze.
"We are backed up against the wall with the IFR going into effect on April 18," said Seth Johnson, vice president of government relations for Pride Mobility Products Corp., Exeter, Pa. Johnson said a leadership void at the Department of Health and Human Services set back the industry's efforts to get the IFR rescinded because federal legislators "really wanted to be respectful of the new administration and not tell [regulators] what to do since there was no leadership."
But, he continued, with a vote on the confirmation of Kansas Gov. Kathleen Sebelius as head of HHS held up until Congress returns from its two-week recess, "now we are seeing some significant concerns being expressed from members of Congress calling for rescission of the rule, and that's exactly what we are looking for. The legislators are now more inclined to weigh in," he said.
The timing is tight, however. "We really have just over another week to build support to get the IFR rescinded," Johnson said, noting that CMS "would most likely make some determination about the IFR" during the week of April 13.
Since CMS issued the IFR in January, there has been a flurry of activity related to competitive bidding with a mixed bag of results.
In a Feb. 12 House hearing, Rep. Heath Shuler, D-N.C., called for an end to the DMEPOS bidding program entirely. But in a March 17 letter, the Medicare Payment Advisory Commission told CMS it supports competitive bidding and urged implementation of the program. The letter did note, however, that lessons learned from the agency's first attempt to get the program going should be incorporated.
MedPAC's comments also included the idea of a "de minimus" policy, which would allow all bidders within a narrow range of the winning bid to be awarded contracts, thus preventing providers bidding just over the winning amount from being eliminated.
Last week, a Senate hearing on competitive bidding was postponed due to scheduling conflicts surrounding Sebelius' confirmation. Called by Sen. Jay Rockefeller, D-W.Va., who has previously favored competitive bidding, the hearing of the Finance Committee's Health subcommittee was not expected to help the industry's position. The hearing could be rescheduled, but when "is a big question mark," Johnson said.
Meantime, HME advocates are preparing an onslaught of congressional visits to lawmakers in their home districts this week and next, along with events in several of the Round One CBAs timed to build support against the IFR.
Reps. Jason Altmire, D-Pa., and Tim Murphy, D-Pa., along with staff from the offices of Sens. Arlen Specter, R-Pa., and Robert Casey, D-Pa., are expected to attend a Pittsburgh event today. Sponsored by the Pennsylvania Association of Medical Suppliers and the Western Pennsylvania Home Medical Equipment Providers Council, the "HME Survival Summit" will give providers and their patients a chance to relay the negative impacts of competitive bidding, a PAMS notice said.
In Cincinnati April 15 and Cleveland April 16, the Ohio Association of Medical Equipment Services will detail the outcome of Round One bidding in public forums called "Medicare DME Competitive Bidding Reality Check." OAMES is encouraging allied health organizations, consumers and patient advocate groups to get informed and get involved in stopping the bidding program.
Johnson said he was also hearing "positive feedback" from a March 31 congressional fundraiser in Dallas. He is hopeful legislators from the Round One bidding areas will craft letters asking for rescission of the IFR to HHS Acting Secretary Charles Johnson, who holds authority to squelch the impending rule.
"Providers' marching orders are to call their local congressional offices and set up a meeting with their representatives and senators to talk about the impact competitive bidding will have on their companies if it goes forward, and ask that their members of Congress send a letter to HHS calling for the IFR to be rescinded," he said.
"We are trying to garner significant political support to have CMS suspend the rule," added Cara Bachenheimer, senior vice president of government relations for Invacare Corp., Elyria, Ohio. But as to whether that will happen, she said, "We really don't know at this point."