Round One Rebid Too Close to Call

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the IFR rescinded because federal legislators “really wanted to be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week to build support to get the IFR rescinded,” Johnson said,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.”