Specter Asks for Recission of IFR as New Bidding Battle Takes Shape

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.