CMS briefs lawmakers on bid program

There are ‘big signs’ of problems, stakeholders say
Friday, November 22, 2013

WASHINGTON – CMS told lawmakers during a briefing on Nov. 18 that they’re investigating reports that some contract suppliers are not servicing their entire bid areas.

Although the briefings were closed to the public, industry stakeholders heard that CMS told lawmakers it’s using secret shoppers to see if contract suppliers are willing to service Medicare beneficiaries that are living in more rural areas.

“When that happens, they begin education,” said Seth Johnson, vice president of government affairs for Pride Mobility. “If the supplier remains out of compliance, they may ultimately terminate the contract.”

CMS held the briefings for Senate staff and staff of the Energy and Commerce and Ways and Means committees.

While stakeholders agree that CMS should be monitoring contract suppliers, they’re not sure the secret shopper program will be that constructive.

“It doesn’t appear that the secret shoppers are particularly educated about the requirements of the program,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Also during the briefing, CMS told lawmakers that they’ve received only about 120 complaints from beneficiaries. That’s in sharp contrast to the number of complaints collected by the People for Quality Care (PFQC). Nearly five months into Round 2, the PFQC’s hotline still averages 35 to 40 calls per day.

“I don’t know how CMS is counting complaints but ours are quite a bit different,” said Kelly Turner, PFQC director. “We have 2,600.”

One of the most common complaints?

“They can’t get a hold of someone at Medicare to help them find a new provider,” said Turner. “They get passed around or put on hold and finally they say, ‘forget it’ and hang up.”

While CMS continues to say the program is running smoothly, recent actions taken by the agency say otherwise, says Bachenheimer.

“They said they weren’t going to issue new contracts in Tennessee, but they did,” she said. “They changed the oxygen policy because these companies are going out of business and leaving patients stranded. Those are big signs there’s a problem. CMS will never admit there’s anything wrong and they control the flow of information.”


No one should be surprised!! 

Of course they KNOW how to police Contracted Providers but they have NO clue how or any DESIRE to police their own contractors!!

The proof is the ACA roll-out of the debacle web-site!!


Wow, if only someone could have seen this coming!! ;)