CMS announces steeper cuts for Round 1 re-compete

Tuesday, October 1, 2013

BALTIMORE – The reimbursement rates for certain home medical equipment will be, on average, 37% lower as part of the Round 1 re-compete of competitive bidding, CMS announced today.

The Round 1 re-compete is scheduled to kick off in nine cities on Jan. 1, 2014.

The reimbursement rates for Round 1 of competitive bidding, which kicked off Jan. 1, 2011, were, on average, 32%, below the current fee schedule.

In the Round 1 re-compete, providers submitted bids for a revamped list of product categories:

• Respiratory equipment (oxygen and CPAP)

• Standard mobility equipment (walkers, manual and power wheelchairs)

• General HME (beds, support surfaces, TENS devices, commode chairs, patient lifts and seat lifts)

• Enteral nutrients

• Negative pressure wound therapy

• External infusion pumps and supplies

The reimbursement rates for the Round 1 re-compete will be, on average, 41% lower for enteral nutrients; 21% lower for external infusion pumps; 47% lower for general HME; 42% lower for negative pressure wound therapy pumps; 40% lower for respiratory equipment; and 34% lower for standard mobility equipment.

CMS’s next steps:

• It will now begin the contracting process.

• In the fall of 2013, it plans to announce the contract suppliers, and begin its supplier, referral agent and beneficiary education campaign.

• On Jan. 1, 2014, it plans to go live with the payment amounts and contract suppliers.

For reimbursement rates:

For average reimbursement rates:$File/R1RC_Average_Savings.pdf

For number of contract offers by bid area and product category:$File/R1RC%20Contract_Offers.pdf


It is clear that CMS wants out of the patient care business and they will do anything to accomplish that goal.  They will choke the supply chain until it stops and then possibly ease up just enough for a provider to barely keep operating. Sure there have been dishonest providers like the Scooter Store however CMS ignored all the complaints about them for almost 20 years before doing anything. CMS should be punished not the providers.

Wait until it all blows up then all the politicians will blame everyone else and not accept responsibility for their reckless acts. It is incredible that smart individuals can act so irrational and reckless.

It is time to get rid of these dangerous politicians, the incompetent bureaucrats and the lazy parasitic people who are bilking our tax dollars and our countries assets before they collectively destroy everything in the USA that is good. 

Agree with your assesment, CMS intentions are clear, they will minimize the number of CPAP providers to the point that patients will buy the equipment themselves without the assistance of Medicare becauise it will so much harder to find a supplier. However what I find amazing is the fact that during all the inquieres in Congress there is no one asking the question "if providers are been push out of business because the unsustainable reimbursement rates implemented by Medicare in Round 2 and now confirmed with Round 1 re compete reimbursement cuts, why insurance rates are still going up?, why if providers are been penalized with lower reimbursements, insurance cost keep  going up? why?" Most people listen to the discussions but do not understand the implications of what is happening. We are increasing the number of cash paid services and many Medicare patients are buying the services, taking advantage of lower prices. We are musch better off selling as a retailer than having to deal with medicare and its outrageous payment terms in most cases pushing the capped items 13 moth rental to 18 or 20 months with constant unjustified denials that must be appeal, adding unnecessary time just to collect the lousy reimbursements. Long live Round 2 and any future round of competitive bidding> Why politians are not clearly telling these facts to the people? because they excempted themselves from Medicare, that is why, because all politians are basically made out of te same raw material,and  personal greed rules in those chambers..  .

As lately many are saying this is in attempt to force people to buy insurance policies with very high deductibles, just for catastrophic events and push patients to pay cash for most of the services. But no one tells the people that this will increase the cost per capita for health care of each insurer because now not only he/her will have he cost of the insurance policy but it will also have to pay out of pocket for the deductible amount..  

Shortsighted and foolish DME dealers don't have enough sense to band together and not accept the bids. CMS would be in a world of hurt with their plan, and forced to change their ludicrous expectations if they found no one to supply the products. Instead, DME suppliers accept the unacceptable because they think they have won something that their competitor cannot have. Accepting bids and thinking this whole thing will blow up is ignorant. It gives a message to CMS that it is okay and sustainable.