WASHINGTON — HME advocates got a boost last week when Sen. Arlen Specter, R-Pa., sent a letter asking HHS to rescind the competitive bidding interim final rule. But the battle over the DMEPOS bid could be tough as the Senate Finance Committee's Health Subcommittee plans a hearing on the program.
The IFR — which reprises the Medicare bidding program following its delay by Congress last July — had originally been scheduled to take effect Feb. 17, but CMS postponed the date for 60 days to give the Obama administration time for review. Since the date delay, industry stakeholders have been working quickly to build support on Capitol Hill for recission of the IFR before its new effective date April 18.
They got it last week in Specter's letter. Addressed to Acting HHS Secretary Charles Johnson, the letter asks for a thorough analysis of competitive bidding before it is implemented a second time.
"Congress delayed the bidding program because it believed the initial roll-out of the program in 2008 had negative results for the four million patients affected and for the hundreds of providers, mostly small businesses, that were excluded from Medicare as a result of the award of first round contracts," Specter wrote. "The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required that several reforms be incorporated into the bidding program. MIPPA addresses several near-term concerns with the program, but thoughtful and deliberate rulemaking by CMS was clearly anticipated by Congress, given congressional and stakeholder concern during initial implementation.
"It is my understanding that the home care community has expressed an interest in working with CMS to review the mechanics of the bidding program," Specter continued. "However, CMS has not utilized the only existing mechanism, the Program Advisory and Oversight Committee (PAOC), to seek or incorporate feedback since MIPPA became law. I am informed that CMS in fact disbanded the initial PAOC, which was created to provide the agency with concrete, real-world guidance on the development and implementation of the bidding program."
Specter recommended the administration rescind the IFR "and do a thorough and complete analysis of the competitive bidding program to determine the best way to move forward for beneficiaries."
But some in the Senate could have different plans. Sen. John Rockefeller, D-W.Va., will convene a hearing of the Health Subcommittee April 1 to address the bidding program.
In June last year, Rockefeller, along with a group of senators including John Kerry, D-Mass.; Dianne Feinstein, D-Calif.; Tom Coburn, R-Okla.; and Larry Craig, R-Idaho, sent a letter to Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Ky., opposing a delay of the bid.
"In light of this past action," the American Association for Homecare said in a Wednesday report, "this hearing is likely to support re-implementation of the bidding program."
"Clearly we are very pleased that Sen. Specter has communicated his support to the acting HHS secretary for rescinding the competitive bidding interim final rule," commented Seth Johnson, vice president of government affairs for Pride Mobility Products, Exeter, Pa. However, he continued, "in order for the industry to be successful in securing that outcome we must remain focused on strengthening the level of congressional support being conveyed to HHS to rescind the IFR prior to its effective date in April."
Once the rule takes effect, Johnson said, it would be "extremely difficult" to get it rescinded. After April 18, CMS is expected to rev up a rebid of Round One with a request for bids.
AAHomecare and numerous other industry organizations have called on HME stakeholders to submit comments on the IFR, due Tuesday, March 17 (tomorrow), by 5 pm ET. "The more the better," emphasized Invacare's Cara Bachenheimer, senior vice president of government relations.
To submit electronic comments, go to www.regulations.gov. Enter file code CMS-1561-IFC and click on "Go." The left-hand column of the next screen is headed "Narrow Results." Under "Document Type," click on "Rules," and that will take you to the actual rule. Click on "Send a Comment or Submission." Fill in the information required under "Submitter Information" and your comments. In your comments, refer to file code CMS-1561-IFC.
View additional information on CMS' DMEPOS Competitive Bidding page.
View the entire rule.