BALTIMORE--In a press briefing last week, acting CMS Administrator Kerry Weems used high gloss to paint the picture of DMEPOS competitive bidding, and, aside from a few queries concerning timing and grandfathering, most of the consumer media had no questions about problems that might surface come July 1. In his opening remarks, Weems told reporters that competitive bidding will make changes that, CMS contends, are long overdue.
“Today we pay fee schedule amounts based on supplier charges from the mid-80s,” Weems said. “The new program represents another way to use the competitive marketplace to bring the best possible and most efficient care and services to beneficiaries.”
In an accompanying press release, Weems said, "Beginning July 1, Medicare beneficiaries will see lower costs for some of their durable medical equipment and supplies--as much as a 43 percent savings for certain items--and the assurance they will have accredited and financially sound suppliers providing them with equipment and supplies."
Weems called the briefing to outline CMS' educational outreach in the first 10 competitive bidding areas, including sending a letter that explains competitive bidding via U.S. Mail to each beneficiary--nearly four million people, according to the release. Weems said the letters would be sent on or "around June 20," just 10 mail days before the round one implementation date.
One reporter asked if that would allow enough time for beneficiaries to gather an understanding of the program and whether they would have enough time to find, if necessary, a new, contracted provider. The reporter said she knew of one patient who receives diabetic supplies and who was having a difficult time locating a contracted provider.
Weems responded that the letters would address all beneficiary concerns.
“We wanted to mail this in time so beneficiaries had time to educate themselves but also so that it is topical. We always walk a fine line between making sure that we provide information in time and making sure that we provide it in a way that is actionable by the beneficiary,” he said.
Weems said the mailing would also include a brochure and a list of the contract winners in each bid area, along with their telephone numbers.
“Similar packets are also being sent to hospital discharge planners, physicians, physician office staff, home health agencies [and] social workers,” Weems said. “On the ground in the 10 areas, CMS regional staff is meeting with provider organizations, beneficiary advocate organizations, area agencies on aging and others to tell them about the changes.”
Further questions to CMS included: “Who is grandfathered? Who is not? And how does anyone know if they are?”
The answer: “To be grandfathered, you simply have to take advantage of the opportunity … There are different rules for different pieces of equipment. The one that is substantially high volume is oxygen. If you have an oxygen concentrator and you are still within the rental period, the 36-month period established by statute for rental of oxygen equipment, if your supplier chooses to grandfather, you will simply stay with that supplier but they will fall under the new rate … We suspect that many, many will [grandfather].”
The questioner followed up with: “So the customer has to contact the provider to find out if they are grandfathered?”
“Or it can work the other way around,” CMS answered. “That's one of the reasons we are educating both sides of the equation, the beneficiaries and the suppliers themselves.”
Weems said beneficiaries could get further information by calling 1-800-MEDICARE or from the Medicare Web site at www.medicare.gov.
A copy of the beneficiary letter and brochure is available by clicking here.