AOPA Summary: Senate Competitive Bidding Proposal
The Senate Finance Committee unveiled October 1, 2002 a bipartisan $43
billion Medicare reform package, the Beneficiary Access to Care and Medicare
Equity Act of 2002. The legislation includes an onerous provision that
would permit competitive bidding for all orthotic services that are not
custom-fabricated.
AOPA has raised strong objections to this provision and is making every
effort to limit the scope of any proposal that would permit competitive
bidding for orthotic devices.
The Senate Medicare competitive bidding proposal would:
–Allow Medicare to competitively bid all orthotic devices, other than
custom-fabricated orthotics as defined by the Secretary of the Department of
Health and Human Services;
–Allow for the continuation of the current Medicare competitive bidding
demonstration projects now underway in Polk County, Florida and San Antonio,
Texas;
–Be phased in over a four-year period with at least ¼ of competitive
bidding areas established in 2003, ½ in 2004 and ¾ in 2005;
–Initially be applied only to Metropolitan Statistical Areas (MSAs) with a
population in excess of 500,000 (about 1/3 of the nation); however, the
Secretary may expand the program to additional areas if he determines that
there is clear evidence that the program will result in savings and will not
reduce access, diversity, product selection or quality;
–Require winning bidders to meet quality and financial standards specified
by the Secretary or developed by accreditation entities or organizations
recognized by the Secretary;
–Require winning bidders to comply with all Federal and State Licensure and
regulatory requirements;
–Exclude entities that have been suspended from the Medicare program by any
DMERC anti-fraud unit for billing for items or services not furnished within
the previous 12 months of submitting a bid;
–Stipulate that bids must be lower than what Medicare would have otherwise
paid including costs associated with the administration of the contract;
–Allow small suppliers to join together to form networks for bidding
purposes, as long as the combined market share of such suppliers does not
exceed 25 percent;
–Sanction various studies to analyze the impact of this proposal including
the effect of competitive bidding on the development of new technology and
the coding of such items;
–Permit competitive bidding for all durable medical equipment and
inhalation drugs used in conjunction with durable medical equipment (other
than items used in infusion therapy); and
–Allow the Secretary to create competitive bidding demonstration projects
for chiropractic, dentistry, physical therapy, occupational therapy,
optometric, etc., services. Physicians were explicitly exempted from any
form of competitive bidding.
American Orthotic & Prosthetic Association (AOPA)
www.aopanet.org
330 John Carlyle Street, Suite 200, Alexandria, VA 22314
Ph: 571/431-0876 Fax: 571/431-0899
Email: [email protected]
