CMS stands ground on Round 1 re-compete

Friday, August 17, 2012

BALTIMORE – With CMS’s announcement last week of the timeline for the Round 1 re-compete, it's likely that recent unpopular changes to the program are here to stay. 

Of particular concern: The re-compete, first announced in April, features about 100 new product codes and six product categories, including an HME category comprising everything from urinals to patient lifts. 

"It's unfortunate that they lumped it into such large categories, but it doesn’t seem like CMS is going to budge," said Cara Bachenheimer, senior vice president of government relations for Invacare. "Once they start announcing detailed timelines, they really don't have an opportunity to make changes."

Key dates announced last week include a bid window that opens Oct. 15 and closes Dec. 14. Registration opens today. 

"The dates fall within what we were predicting," said Mark Higley, vice president of development for The VGM Group, who is leading a series of bidding seminars this fall on the Round 1 re-compete.

It is that sort of steady stream of education that has stakeholders optimistic, that, if nothing else, providers will better understand the process this time around.

"There are a lot of programs and information out there being supplied," said Wayne Stanfield, president and CEO of NAIMES. "I think in that respect providers are better prepared."

The bidding program has forced some providers to close their doors, and stakeholders worry things are about to get a lot worse.

"CMS has taken this from a nine-location pilot to expanding it more than nationwide and we are disappointed that CMS continues to reject input and advice from the homecare community," said Walt Gorski, vice president of government affairs for AAHomecare.

With the Round 1 re-compete and Round 2 now both in play, is it game over for the industry's market-pricing program? Not necessarily, stakeholders say.

"We've known there was going to be activity in the fall so we are just going to have to deal with it," Bachenheimer said. "The question is: Can we glean some of the ill effects out of these developments and advance MPP on the Hill."