CMS on notice to follow licensure rules

Friday, May 1, 2015

WASHINGTON – While most of the attention on recently passed legislation has focused on binding bids, another provision aimed at improving the competitive bidding program has essentially already taken effect: licensure.

“This is not something that Congress should have had to do but a lot of folks were completely incensed that CMS was just blithely offering contracts to companies,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “This sends a strong message from Congress to CMS that you better be sure the people you offer contracts to are licensed.”

That includes for the Round 2 re-compete, for which the bid window closed on March 26.

CMS’s own rules dictate that providers meet licensure requirements for the states in which they submit bids, but when contracts were awarded in Round 2 back in 2013, hundreds went to suppliers that didn’t meet those requirements, including more than 100 in Maryland.

Adding insult to injury: Many contracts went to providers located hundreds or thousands of miles from competitive bid areas. Since then, several states, including Alabama, have enacted licensure laws that require providers to have a physical presence in the state.

“I think most providers are being smarter, but what you don’t know are the wild cards—the speculators throwing out bids that are not committed to serving beneficiaries in those areas,” said Bachenheimer.

Some providers say they have learned from earlier rounds of competitive bidding what not do. Jamie Blair, for one, stuck to his own backyard yard when he recently rebid in the Round 2 re-compete.

“Last time, we bid around the country and won, and went the subcontracting route,” said Blair, vice president of Genesis Respiratory Services in New Boston, Ohio. “This time, we just bid in areas where we actually had service. It’s not worth it. It was more of a hassle.”