The House of Representatives passed a Medicare prescription drug
benefit bill June 28 that in addition to providing the drug benefit
would require the Secretary to establish and implement competitive
bidding programs for durable medical equipment, including some
off-the-shelf orthotics Under the proposed system, the Secretary of
Health and Human Services (HHS) would be required to enter into
contracts with suppliers for “competitive acquisition areas” for
not longer than three years in duration. The items to be subject to
competitive bidding would be durable medical equipment and
inhalation drugs used with durable medical equipment, as well as
“off-the-shelf orthotics,” defined as covered orthotics which
require minimal self-adjustment for appropriate use and do not
require expertise in trimming, bending, molding, assembling, or
customizing to fit the patient.. Although it is unclear as to
exactly which orthotic products this would include, preliminary
analysis of what CMS would be required to determine through
regulation would likely include approximately one-third of all
orthotics.
The Senate is now considering a Medicare prescription drug
package that does not currently contain competitive bidding or any
other “provider giveback” provisions. However, the way the
legislation is being considered leaves open the possibility that
competitive bidding may be offered as an amendment. It is likely,
though, that substantive action on competitive bidding will occur
in September when the Senate Finance Committee will mark up a
“provider giveback” package. That package will almost certainly
consider competitive bidding. Until then, it is imperative to
remain on guard for any possible amendments to the legislation
being considered in the Senate right now as well as continue to
prepare to fight competitive bidding in the fall.
