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Competitive Bidding:

CMS RELAUNCHES DME COMPETITIVE BIDDING PROGRAM

Published on Fri Jan 23, 2009

Despite some changes, major flaws remain,industry reps charge.

Suppliers hoping for a significantly restructured competitive bidding program from Medicare were sorely disappointed with a new rule that will take effect next month.

In the Jan. 16 Federal Register, the Centers for Medicare & Medicaid Services issued a new interim final rule on competitive bidding for durable medical equipment. CMS will take comments on the final rule for 60 days, but the rule actually goes into effect Feb. 15.

Timeline: CMS plans for round one to occur in 2009, mail order bidding "after 2010," round two in 2011, and subsequent rounds in later years.

The rule does set out some differences from the 2008 program that was delayed by Congress in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). It excludes negative pressure wound therapy (NPWT) and Group 3 complex rehabilitative wheelchairs, CMS notes on its bidding Web site. Those exclusions were required by MIPPA.

CMS will also provide feedback about missingbid documentation, as required in the law. "Suppliers that submit financial documents within ... the covered document review date will be notified by CMS regarding any missing financial documentation," the agency explains on its site. Notified bidders will then have 10 business days to submit the proper information to CMS.

"This notice only applies to the receipt of the financial documents," CMS warns. "It does not include a review of the accuracy of the documents submitted or whether the documents meet applicable requirements."

The rule also addresses subcontracting.

"While contract suppliers may use subcontractors for certain limited services, the contract suppliers retain responsibility for ensuring that all services under their contracts are appropriately furnished," CMS says. "Contract suppliers must also provide information on whether each subcontractor meets the applicable accreditation requirements."

9 MSAs: CMS also cuts one of the 10 metropolitan statistical areas from bidding -- San Juan. The other MSAs remain in the round one rebid: Cincinnati-Middletown (Ohio, Ky. and Ind.); Cleveland Elyria-Mentor (Ohio); Charlotte-Gastonia Concord (N.C. and S.C.); Dallas-Fort Worth-Arlington (Texas); Kansas City (Mo. and Kan.); Miami-Fort Lauderdale-Miami Beach (Fla.); Orlando (Fla.); Pittsburgh (Pa.); Riverside-San Bernardino-Ontario (Calif.).

Finally, CMS announced the new members of the bidding Program Advisory and Oversight Committee (PAOC).

"Congress called for a delay of the program and made certain changes, which this new regulation carries out," CMS acting administrator Kerry Weems says in a release. "Implementing the law's changes and appointing members to the program's oversight committee are the first steps to take to restart the competitive bidding process."

Industry Reps Blast New Rule

But the supplier community is far from satisfied with the changes CMS made to the program."The fundamental problems associated with the bidding remain," says Tyler Wilson with the American Association for Homecare. "This program will actually reduce competition, reduce access to care for seniors, reduce patient choice, reduce quality, and put good providers out of business."

"By issuing an interim final rule instead of a proposed rule, CMS has bypassed the traditional notice and comment process that takes place prior to implementation," says the Power MobilityCoali-tion. "The fact that the rule will be in place a month before public comments are due indicates that CMS failed to take the appropriate time, including soliciting input from medical equipment stakeholders, to properly examine the program."

"The rule reflects the same grave concerns facing suppliers as when the delay was won in Congress," laments the National Association of Independent Medical Equipment Suppliers. "With a few exceptions mandated by MIPPA, the rule remains the same and contains the same flaws the industry has pointed out time after time."

Note: CMS's bidding information is at www.cms.hhs.gov/DMEPOSCompetitiveBid/01_overview.asp.

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