CMS holds first meeting on ncb

Sunday, October 10, 2004

October 11, 2004

BALTIMORE - CMS, at the first meeting of the Program Advisory Oversight Committee in Baltimore last week, upended expectations that the 10 largest MSAs would be subject to competitive bidding in 2007. Instead, CMS said it was targeting ‘10 of the largest’ MSAs for the first two years of competitive bidding.
“I think if you’re in any of the 50 largest MSAs, it’s fair game,” said Cara Bachenheimer, Invacare’s vice president of government relations and a PAOC member. “That was pretty shocking to a lot of people.”
At the all-day meeting here last Wednesday, CMS and its contractor on the competitive bidding initiative, the Research Triangle Institute, presented a series of reports that
- evaluated the competitive bidding demonstration projects in Polk County, Fla. and San Antonio, Texas;
- proposed a timeline for the development of the project;
- posed various structural issues for the committee’s evaluation (i.e. How will the DMERCs process claims under competitive bidding?)
- and considered quality standards issues.
The meeting drew all but one of 21 previously announced appointments to the PAOC, and one late addition - Seth Johnson, director of government affairs at Pride Mobility products. (For a complete list, see the Sept. 27 HME Newswire), The meeting also attracted an audience of 50-75 HME industry personnel, who were not allowed to participate in the discussion.
At the outset, Herb Kuhn, the director of the Center for Medicare Management, told the committee that CMS welcomed comments and a debate on the subject matter but reserved the right to make decisions independent of consensus by the committee.
Some industry representatives said they would prefer that CMS achieve consensus before deciding which cities to move on first or which products to put up for bid
Although many were surprised by the revelation that CMS had the discretion to choose which 10 cities to select for 2007, in section 302 of the MMA, the legislative language does state that competitive bidding will be rolled out in “10 of the largest metropolitan statistical areas in 2007.”
On the issue of accreditation, the RTI discussed multiple approaches to the fulfilment of an MMA provision that will implement more rigorous quality standards for DME suppliers. The choices seemed to boil down to whether CMS would appoint one accrediting body, several bodies or to simply accredit suppliers themselves.
The law states that CMS must “designate” or “approve” a “recognized independent accreditation organization” to apply new quality standards established by the Medicare program’s overseer.
CMS distributed a 346-page evaluation of the competitive bidding demonstration projects that echoed earlier summarys of RTI’s findings.
“The staff report says that CMS met its objectives in the demonstration projects, and that there is a potential for savings,” said Asela Cuervo, who represents AAHomecare on the committee. “To be honest, it didn’t sound too different from earlier reports.”
After reading the first 100 pages of the report, Mary Behardus, a PAOC member and owner of Handi Medical Supply, said that reading the report has stimulated questions about the researcher’s methodology.
“I am moved to contact some of those store managers [in Polk County and San Antonio] to ask my own questions and then comment on what is potentially an oversight,” she said. “I need to contact the stores to understand their perspective.”
The PAOC will meet again Dec. 6 – 7 in Baltimore.