A U.S. House of Representatives bill that would stop the Medicare competitive bidding program has gained the bipartisan co-sponsorship of 112 Representatives-more than one quarter of the entire House-many of them having joined in the past month. H.R. 3790, titled, “To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner,” has been under fire from a number of organizations, including the VGM Group and Accredited Medical Equipment Providers Association (AMEPA). According to HME News, AMEPA recently told members that the Government Accountability Office (GAO) report on Round 1 of competitive bidding predicted that if the program was implemented nationwide, 88 percent of DMEPOS providers would have to close their doors. On November 23, VGM Group sponsored a “shutdown the switchboard” event and estimates that more than 30,000 calls supporting the bill went to the Capitol switchboard.
“Providers in and around the nine round one competitive bidding areas are currently going through the bidding process, and stand to learn their fate by next summer, with the likelihood that approximately 90 percent of local bidding entities will not be offered contracts and contracted suppliers will face cuts of greater than 30 percent below the 2008 allowables,” the VGM Group states on its website. “Round two bidding entities, likely including 91 additional bidding areas, are to bid in 2011 and learn their fate as a Medicare providers shortly thereafter. Providers in non-competitively bid areas also face the inevitable in that bid rates will ultimately be spread to non-bid areas. Also, Medicaid and private insurers are monitoring this program closely and are set to cut rates as soon as results are announced.”
The Centers for Medicare and Medicaid Services (CMS) have already moved to improve the program. “CMS has taken several steps to improve the bidding process for the round 1 rebid and subsequent rounds of the CBP [competitive bidding program],” the GAO stated in its report. “CMS is implementing MIPPA [Medicare Improvements for Patients and Providers Act of 2008] provisions to notify suppliers of missing financial documentation and create a CBP ombudsman. It has reduced financial documentation requirements and revised the request for bid instructions to make it clearer and more understandable. It is also developing a new electronic bidding submission system, the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies bidding system (DBidS), which the agency claims will address the deficiencies of the system used for round 1. Bidding for the round 1 rebid began in late October 2009. The CBP has the potential to produce considerable benefits, including reducing overall Medicare spending for DME and limiting potential fraud through increased scrutiny of suppliers. Although challenges may be expected for any new program, problems occurred in round 1 because of poor communication by CMS and an inadequate bid submission system.”
