HALIFAX, Va. — Initial responses to a NAIMES survey on how the HME industry should deal with competitive bidding make it pretty clear that stakeholders want to keep battling to stop the program, but they're not so united on what should take its place.
"A significant portion of people have a lot of ideas about what the alternative to bidding would be," said Wayne Stanfield, president and CEO of the National Association of Independent Medical Equipment Suppliers.
As of last week, the organization had received 98 responses to the survey, which asks what the DME industry should do now and what alternative to the CMS bidding program the respondent would choose.
While Stanfield had not completed a detailed analysis, he said, "It is pretty clear that the majority of the people want to continue the fight for [H.R. 1041] but do anything possible to stop Round 2 from going forward."
Introduced in March by Reps. Jason Altmire, D-Pa., and Glenn "GT" Thompson, R-Pa., H.R. 1041 would repeal competitive bidding and "pay for" it with $20 billion in undesignated discretionary funds. The bill had 133 cosponsors as of Monday.
But it is the answer to the question about an alternative to the bidding program that Stanfield found most interesting, he said.
About 15 percent of the respondents said MEDPAC or another government panel should set prices, while 7 percent said a manufacturer bidding program should do it. Another 25 percent said the current pricing is fine, while 35 percent offered other options. Around 18 percent said competitive bidding should be repealed and replaced with an auction designed by Peter Cramton, the University of Maryland economist who has mounted a continuing campaign against the flaws in CMS' bidding design.
Through warnings to Congress, a mock auction event and a letter to President Obama, Cramton has been relentless in his resolve to stop the current competitive bidding program and get it redesigned. He has crafted legislative language for a "repeal and replace" proposal that would halt Round 1 and reinstitute administrative pricing for HME until an independent expert designs a new auction. Last week, he released a study underscoring dramatic marketplace changes in the Round 1 competitive bidding areas since the program was implemented in January.
The idea of any auction/bidding program has been a hard sell to the HME industry. But Stanfield's initial results seem to indicate that some providers, at least, are interested in Cramton's proposal.
"At least another six or seven also said yes to Cramton, but they added some caveats," Stanfield said. That pushes the total number of respondents who support the economist's auction proposal to 20-25 percent.
Stanfield said it is important "for the industry to be cautious and reflective" about any new concept. However, he added, there needs to be an alternative to the CMS competitive bidding program, "and the only one being advanced with any degree of impetus is Cramton's auction proposal.
"There is nothing else on the table," he said, "and I do not believe that CMS is going to stop on their own."
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