Pressure’s On for CMS to Make Changes to DMEPOS Competitive Bidding

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.”