ATLANTA — Although cautious about appearing to embrace the idea of a competitive bidding redesign, providers will be at the table in College Park, Md., when economist Peter Cramton puts on a mock auction for home medical equipment at the University of Maryland.
Most industry advocates are looking for a repeal of the bidding program rather than a redesign as Cramton is suggesting. Nevertheless, association representatives said, they plan to attend the April 1 Medicare conference and auction demonstration.
"I don't agree with Dr. Cramton's idea of redesigning the program," said Rob Brant, president of the Accredited Medical Equipment Providers of America. "But I look forward to the opportunity to explain to him face-to-face why it won't work with DME."
The American Association for Homecare, which is pushing for legislation to repeal competitive bidding, also sees the conference as a place to explain HME to legislators, regulators and economists.
"We believe that bidding is not appropriate for the medically required equipment and services that [HME suppliers] provide in the homes of frail seniors and people with disabilities, so the association strongly favors repeal of the entire bidding program," said President Tyler Wilson. "AAHomecare plans to participate at the mock auction and make those views known."
While Cramton has focused attention on the severe problems in the bidding system, Wilson said, "We draw a different conclusion about whether the program can be fixed."
Last fall, the economics professor and 166 of his colleagues sent a letter to Congress warning that CMS' design of the program was fatally flawed. Cramton said he is staging the mock auction to illustrate how a well-designed competitive bidding program — or auction — would operate. He has opened the event to HME providers, congressional staff, representatives of CMS, the Department of Health and Human Services, the Office of Management and Budget and other government entities.
In a letter of invitation, Cramton wrote that he hoped providers would come "to contribute your industry expertise and knowledge to [e]nsure service, quality and all necessary requirements are properly considered, and to learn how a fair and sustainable program would operate, so that you can profitably provide quality products and services and compete on that basis."
In an update this morning, Cramton said that "government representatives so far are coming from CBO, CEA, MedPAC, FCC, FAA, USDA and NSF," and that "HHS has said that they will be there." Dozens of registrations have also come in, he said, from both "some of the largest providers and some small providers."
According to Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers, "If you think of this as an opportunity where there may be [congressional] staffers to hear how bad this particular bidding program is, it might be a really good thing to be there nodding, if nothing else. My point is, it is an opportunity I do not think we can afford to miss."
Stanfield said a dozen members of NAIMES have already reserved spots at the conference, and he is campaigning for others to attend. He does not believe that by attending the conference he is supporting the idea of a program redesign vs. its repeal. He does believe that competitive bidding must be stopped and that Cramton could have the key to doing that.
"We have to understand that nothing really matters in this industry except stopping competitive bidding, and if this will help do that, then we need to help it do that," Stanfield said.
John Shirvinsky, executive director of the Pennsylvania Association of Medical Services, said he also plans to attend. "There's pretty broad interest in the industry in paying attention to this and monitoring what it is that [Cramton] really wants to do," he said, even though stakeholders diverge from the auction expert on whether competitive bidding is appropriate for HME.
"Cramton has become an important guy in the debate," the PAMS director said. "The work he has done is very important in critiquing the primary flaws in the design of the auction … People need to take seriously what he and the others who signed the [economists' letter] are pointing out."
AMEPA alerted its members to the conference in a message that read, "The HME industry needs to be on guard against promoting a new bidding program, but we need to continue to use any means available to demonstrate there are problems. Be aware of this event; it may be wise to be there just to make sure the truth is told."
For his part, Stanfield believes that any provider who can be at the auction conference should be there. "It is an opportunity to listen and learn and also an opportunity to be behind the one person outside of this industry that is saying very loudly that this program is flawed and won't work," he said.
"I want the 150 seats he has reserved for suppliers to be filled with suppliers — every one of them."
Registration at the conference is free for those from the government and $80 ($100 after March 14) for non-government participants. For more information on the auction event, see Cramton's website. Register at www.123sigup.com.
View more competitive bidding stories.