CMS holds first meeting on NCB

Tuesday, November 30, 2004

BALTIMORE - CMS, at the first meeting of the Program Advisory Oversight Committee in Baltimore Oct. 6, 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, 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?);

- Considered quality standards issues.

At the meeting’s outset, Herb Kuhn, the director of the Center for Medicare Management, told the committee that CMS welcomed comments and 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 what 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 fulfillment 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 PAOC will meet again Dec. 6 – 7 in Baltimore. HME