Medicare Compliance & Reimbursement

Competitive Bidding:

DME Suppliers Besiege Congress

House hearing puts CMS on the defensive as companies step up their campaign Durable medical equipment suppliers seem to be gaining traction in their fight against Medicare competitive bidding, but will it be enough to stave off the industry-threatening program? DME suppliers have been waging a major grass-roots campaign aimed at stopping or at least delaying round one of competitive bidding, which starts July 1. Supplier groups like the American Association for Homecare and the National Association of Independent Medical Equipment Suppliers have submitted to lawmakers petitions with thousands of signatures calling for a bidding delay, submitted letters urging bidding action, placed an ad in Roll Call decrying the program, and organized supplier fly-ins to lobby members of Congress. Oxygen patients have roamed the halls of Congress to persuade their representatives. Numerous suppliers and DME users have visited lawmakers at home and in Washington, DC, to press their case to end or delay bidding. Suppliers point to the high rate of disqualified bids as one of the many flaws in the program. The Centers for Medicare & Medicaid Services says it disqualified 4,874 of the 6,209 bids submitted for round one, according to the Dallas Morning News. More than 3,000 of those were for missing documentation or lack of accreditation. Lawmakers, take notice: That was one of the many issues raised May 6 in the House Ways and Means Health Subcommittee's hearing on bidding. Committee members including Chairman Pete Stark (D-CA) took CMS Acting Administrator Kerry Weems to task for bidding's implementation problems. Weems said CMS staffers spot-checked 100 disqualifications and that they were all correct. Committee members seemed irritated when Weems would admit no faults in the program and would offer no suggestions for improvement in future rounds, attendees say. Former American Association for Homecare head Tom Ryan detailed a long list of problems with the program in his testimony before the committee. "This Medicare bidding program is a train wreck. But as this program jumps off the tracks, the attitude of CMS is clearly 'full steam ahead,' " said Ryan, now CEO of Homecare Concepts in Farmingdale, NY. "The bidding program is poorly conceived and fundamentally flawed." Also, suppliers that CMS requires to be accredited can use unaccredited subcontractors, says the National Association for Home Care & Hospice. Before the hearing, Stark told the Wall Street Journal he might want to entirely "scrap" the program. During the hearing, Stark asked Ryan whether suppliers would take a Medicare rate cut in exchange for halting the bidding program. Ryan indicated yes. Industry reps generally agree that "an across-the-board fee cut would be a much more acceptable way to save money for Medicare than going forward with the flawed competitive bidding [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.