CMS reverses stance on financial capacity

Thursday, November 14, 2013

WASHINGTON – HME providers in the competitive bidding program may no longer decline referrals after reaching their financial capacity, according to AAHomecare.

In a recent bulletin, the association said it has received clarification from the Competitive Bidding Implementation Contractor (CBIC) that this is no longer acceptable.

“AAHomecare has had several discussions with the CBIC expressing that financial capacity is a real issue with potentially devastating impact,” the bulletin reads. “With the number of contracts awarded to companies hundreds of miles outside of bidding areas, local providers are overwhelmed with requests.”

The official guidance from the CBIC includes: Providers must furnish all items in the product categories and bid areas for which they have contracts, or risk having those contracts terminated. Additionally, providers are not permitted to “pick and choose” beneficiaries.

CMS says it examines the financial capacities of providers as part of the bidding process to make sure it awards enough contracts to meet demand.

AAHomecare says it will continue to discuss this issue with the CBIC.